Upload
others
View
3
Download
0
Embed Size (px)
Citation preview
Health Net of California, Inc. and Health Net Life Insurance Company (Health Net)
Health & Wellness Programs and Services A GUIDE FOR MEMBERS
Coverage for every stage of life™
Choose Health – Take Action Pursuing better health is our best defense against chronic medical conditions. That’s why we created Decision Power®: Health & Wellness. With personalized tools and achievable goals, you can feel confident in your ability to make positive and lasting behavioral changes.
A bridge to healthy actions Decision Power is a set of programs, created to engage people in their health. What you get is a bridge between knowing how to improve your health and wellness, and gaining the support and confidence to take action.
Our Decision Power programs encompass health and wellness, integrated care management, case management, and women and children’s health.
Health & Wellness online
You can access most Decision Power: Health & Wellness programs and services anytime, anywhere.
Look for the icon throughout this brochure to identify programs with online access.
2
Healthy Lifestyle
Get to Know Health Net’s Decision Power: Health & Wellness!
Health Risk Questionnaire and Personal Health Record
Staying healthy is as important as getting better. That’s why we offer tools like our Health Risk Questionnaire (HRQ) and Personal Health Record (PHR).
These self-directed, preventive care resources connect you to personalized information about your behavioral and medical health risks, along with a personalized action plan.
Based on your unique health needs, you’ll receive recommendations to programs and resources to help you better manage your health and promote healthy habits. You can also opt in to receive emails with updates and valuable program information.
myStrength – Strengthening Mind, Body and Spirit
myStrength is a confidential online resource, personalized to help improve your mood. The program’s self-help tools are designed to help empower you to become – and stay – mentally and physically healthy. myStrength supports whole-person health, addressing topics like pain management, substance use, insomnia, depression, anxiety, and prenatal and postpartum behavioral health.
HERE ARE SOME PROGRAM HIGHLIGHTS: • In-the-moment tracking.
• Interactive tools.
• Immediate stress-relieving tips.
• Weekly action plans.
• A variety of mood-improving activities.
• Daily inspiration.
• Mobile app.
• Step-by-step eLearning modules.
• A site that’s highly confidential and HIPAA-compliant1 – for member privacy!
• All this is included at no additional cost!
You can access the HRQ online and sign up for myStrength by logging in to:
• www.healthnet.com (Group members)or • www.myhealthnetca.com (Individual & Family Plan members).
1Health Insurance Portability and Accountability Act, a 1996 federal law that restricts access to individuals’ private medical information.
3
Health Promotion Programs
Looking for a more flexible way to improve your health and wellness – on your own terms? Then thesecomprehensive behavior-change programs may be ideal. Our Health Promotion programs offer a self-directed, online path to achieving and maintaining health goals.
These programs include achievable goals, personalized to your preferences and interests. Program topics include:
• Reach a Healthy Weight.
• Improve Your Diet.
• Feel Less Stress.
• Be More Active.
• Live Tobacco-Free.
• Managing Type 2 Diabetes.
• Managing High Blood Pressure.
Each program focuses on one health topic and includes a to-do list of action items to help you reach your goals. And these programs are available online, so you can take steps for positive and lasting change when and where it’s most convenient!
Online Seminars
You’ll have fun with our engaging seminars, which cover important health topics, while helping you take steps to live a healthier lifestyle. A new seminar is available the first of each month. Each complimentary seminar contains a topic-related article for easy printing.
Wellness Health Coaching
You can improve your health by interacting with a virtual health coach online or by engaging with a live health professional by telephone. Coaching outreach is driven by your specific needs. The program offers flexible communication, including secure email, eLearning modules and telephone. The online features include coaching tools like journaling, goal-setting and exercise/food trackers.
Start Smart for Your Baby® Program
Start Smart for Your Baby (SSFB) is a program for pregnant and new moms, providing custom support and care for a healthy pregnancy and baby. Sign up to receive health education materials, such as Mother’s Guide to Pregnancy and Guide to Life After Delivery, and guidance from a care manager throughout your pregnancy.
Quit For Life®
The Quit For Life tobacco cessation program covers any type of tobacco, including the use of Electronic Nicotine Delivery Systems (ENDS), such as e-cigarettes and e-pipes. The program lets you talk with a quit coach for encouragement and support, and offers a personalized plan to quit. Here are some highlights of the program:
• In-depth assessment andpersonalized cessationplans, with medication supportrecommendations.
• Up to four proactive, one-on-onecounseling calls, plus unlimitedcalls to our program clinicians.
• Quit For Life participant toolkit – Quit Guide.
• Helpful toolkit for family and friends– Ally Guide.
• Access to our Text2Quit tool.
Online Chronic Condition Resources
If you have an existing health condition, we offer online informational centers with tools and resources to help you stay healthy for the long term. You’ll access articles, videos and interactive tools, all organized by condition. Conditions include diabetes, heart disease, high cholesterol, asthma, high blood pressure, cancer, and more.
Integrated Care Management
Health Net’s Integrated Care Management program supports and coordinates health care for members with complex physical, behavioral and psychosocial health issues, as well as members with chronic conditions, such as diabetes, asthma, congestive heart failure (CHF), or coronary artery disease (CAD). The program supports Health Net members, families and caregivers to help members achieve the best health, functional ability and quality of life through improved management of their disease or condition.
We offer a dedicated
Quit For Life website with
helpful information, a chat
function and learning
modules.
4
Smart Treatm
ent Decisions Smart Treatment Decisions
Smart Treatment Decisions is an online resource that offers decision points about:
• Medical tests.
• Medicines.
• Surgeries.
• Treatments and other issues.
With these decision points, you can focus on making informed health decisions by considering the benefits, risks and costs of each option, as well as how you feel about your condition.
Medications With this tool, you’ll learn about side effects, interactions, precautions, and more, including details about taking medications as prescribed, and tools to help you make better-informed decisions about medications.
Surgeries and procedures Before making a decision about having surgery or a major procedure, you can use this tool to get informed and learn the basics about what to expect with different types of surgeries and procedures.
Take Charge of Your Health Program
Take Charge of Your Health, helps you better manage your chronic medical conditions through tailored wellness strategies and healthy behaviors you can stick to.
You’ll follow a self-paced, online set of actions that count toward milestones and encourage you to take a more active role in your health.
Type 2 diabetes and high blood pressure management are the first conditions supported under this new focus area with additional conditions soon to follow.
5
Mor
e To
ols
and
Reso
urce
s Nurse Advice Line
You can reach out to a clinician – 24 hours a day – and get instant support via telephone or by using the online chat system to ask questions in real time. You’ll also get answers to questions about symptoms, minor illnesses or injuries, chronic conditions, medical tests, and medications.
Progress Trackers
You’ll stay up-to-date on important lifestyle habits using a variety of online tracking tools. Our progress trackers are available for blood pressure, cholesterol, HbA1c, exercise, stress management, and more. You can access these trackers individually as standalone tools or as a part of our Health Promotion programs.
Interactive Health Conversations
You can interact and get inspired with virtual health advisors. You’ll engage in short virtual conversations on a host of health-related topics, including:
• Getting active.
• Healthy weight.
• Dealing with stress.
• Sleeping well.
• Preventing falls.
• Quitting smoking.
To get started with interactive health conversations:
• Log in to www.healthnet.com (Group members) or www.myhealthnetca.com (Individual & Family Plan members).
• Click on Wellness Center.
• Click on Explore All Wellness Tools.
• Click on the Member ResourceCenter tab.
• From the drop-down, click onWellness Resources and thenConversations.
6
Useful monthly newsletters
can help you make smart
decisions that can improve
your health.
Health N
et Mem
ber Extras Healthy Discounts
You’ll enjoy discounts on a variety of health services, programs and tools. These services include:
• Weight management.
• Chiropractic and acupuncture.
• Vitamins, minerals and herbal supplements.
• Eye care.
• Hearing aids and screenings.
• Fitness club.
Preventive Screening Guidelines
These guidelines offer a schedule of Health Net’s recommended health screenings and immunizations for children, adolescents and adults. These guidelines also provide information about pediatric and maternity screenings.
You can find the current preventive screening guidelines by logging in to www.healthnet.com (Group members) or www.myhealthnetca.com (Individual & Family Plan members). After logging in, click on Wellness Center then Stay Healthy, and choose the Preventive Guideline PDF that fits your situation.
Monthly Wellness Webinars
You’ll access monthly health topics via webinars at work or at home. Topics vary and include Financial Wellness, Mindfulness, and Cold and Flu.
Health Net offers the Wellness Webinar Series the third Wednesday of each month. Group members log in to www.healthnet.com, and Individual & Family Plan members log in to www.myhealthnetca.com. Click on the orange New Series Wellness Webinar button to register.
7
Japanese無料の言語サービスを提供しております。通訳者もご利用いただけます。日本語で文書をお読みすることも可能です。ヘルプが必要な場合は、IDカードに記載されている番号で顧客連絡センターまでお問い合わせいただくか、Individual & Family Plan (IFP) (個人・家族向けプラン) Off Exchange: 1-800-839-2172 (TTY: 711) までお電話ください。カリフォルニア州のマーケットプレイスについては、IFP On Exchange 1-888-926-4988 (TTY: 711) または Small Business 1-888-926-5133 (TTY: 711) までお電話ください。Health Netによるグループプランについては、1-800-522-0088 (TTY: 711) までお電話ください。
Khmerសេវាភាសាសោយឥតគិតថ្លៃ។ សោកអ្នកអាចទទួលបានអ្នកបកប្បផ្ទា ល់មាត។់ សោកអ្នកអាចសាដា បស់គអានឯកសារឱ្យសោកអ្នកជាភាសារបេ់សោកអ្នក។ េ្មាបជំ់នួយ េូមសៅទូរេ័ពទាសៅកានម់ជ្ឈមណ្ឌ លទំនាកទ់ំនងអតិ្ិជនតាមសលខបែលមានសៅសលើបណ័្ណ េមាគា ល់ខលៃួនរបេ់សោកអ្នក ឬសៅទូរេ័ពទាសៅកានក់ម្មវធិី Off Exchange របេ់គស្មាងជាលក្ខណៈបុគគាល និង្ករុម្គរួសារ (IFP) តាមរយៈសលខ៖ 1-800-839-2172 (TTY: 711)។ េ្មាបទី់ផ្សាររែ្ឋ California េូមសៅទូរេ័ពទាសៅកានក់ម្មវធិី On Exchange របេ់គស្មាង IFP តាមរយៈសលខ 1-888-926-4988 (TTY: 711) ឬ្ករុមហុ៊នអាជីវកម្មខ្្ន តតូចតាមរយៈសលខ 1-888-926-5133 (TTY: 711)។ េ្មាបគ់ស្មាងជា្ករុមតាមរយៈ Health Net េូមសៅទូរេ័ពទាសៅកានស់លខ 1-800-522-0088 (TTY: 711)។
Korean무료 언어 서비스입니다. 통역 서비스를 받으실 수 있습니다. 문서 낭독 서비스를 받으실 수 있으며 일부 서비스는 귀하가 구사하는 언어로 제공됩니다. 도움이 필요하시면 ID 카드에 수록된 번호로 고객서비스 센터에 연락하시거나 개인 및 가족 플랜(IFP)의 경우 Off Exchange:1-800-839-2172(TTY: 711)번으로 전화해 주십시오. 캘리포니아 주 마켓플레이스의 경우 IFP On Exchange 1-888-926-4988(TTY: 711), 소규모 비즈니스의 경우 1-888-926-5133(TTY: 711)번으로 전화해 주십시오. Health Net을 통한 그룹 플랜의 경우 1-800-522-0088(TTY: 711)번으로 전화해 주십시오.
NavajoDoo b33h 7l7n7g00 saad bee h1k1 ada’iiyeed. Ata’ halne’7g77 da [a’ n1 h1d7d0ot’88[. Naaltsoos da t’11sh7 shizaad k’ehj7 shich9’ y7dooltah n7n7zingo t’11 n1 1k0dooln77[. !k0t’4ego sh7k1 a’doowo[ n7n7zingoCustomer Contact Center hooly4h7j8’ hod77lnih ninaaltsoos nanitingo bee n44ho’dolzin7g77 hodoonihj8’bik11’ 47 doodago koj8’ h0lne’ Individual & Family Plan (IFP) Off Exchange: 1-800-839-2172 (TTY: 711). California marketplace b1h7g77 koj8’ h0lne’ IFP On Exchange 1-888- 926-4988 (TTY: 711) 47 doodagoSmall Business b1h7g77 koj8’ h0lne’ 1-888-926-5133 (TTY: 711). Group Plans through Health Net b1h7g77 47koj8’ h0lne’ 1-800-522-0088 (TTY: 711).
Persian (Farsi)خدمات زبان بدون هزينه. می توانيد يک مترجم شفاهی بگيريد. می توانيد درخواست کنيد اسناد به زبان شما برايتان خوانده شوند. برای دريافت کمک، با مرکز تماس مشتريان به شماره روی کارت شناسايی يا طرح فردی و خانوادگی IFP( Off Exchange) به شماره:
TTY:711( 1-800-839-2172( تماس بگيريد. برای بازار کاليفرنيا، با IFP On Exchange شماره 1-888-926-4988)TTY:711( يا کسب و کار کوچک 1-888-926-5133 )TTY:711( تماس بگيريد. برای طرح های گروهی از طريق
Health Net، با TTY:711( 1-800-522-0088( تماس بگيريد.
Nondiscrimination Notice In addition to the State of California nondiscrimination requirements (as described in benefit coverage documents), Health Net of California, Inc. and Health Net Life Insurance Company (Health Net) comply with applicable federal civil rights laws and do not discriminate, exclude people or treat them differently on the basis of race, color, national origin, ancestry, religion, marital status, gender, gender identity, sexual orientation, age, disability, or sex.
HEALTH NET: • Provides free aids and services to people with disabilities to communicate effectively with us, such as qualified sign language
interpreters and written information in other formats (large print, accessible electronic formats, other formats).
• Provides free language services to people whose primary language is not English, such as qualified interpreters and information written in other languages.
If you need these services, contact Health Net’s Customer Contact Center at:Individual & Family Plan (IFP) Members On Exchange/Covered California 1-888-926-4988 (TTY: 711)Individual & Family Plan (IFP) Members Off Exchange 1-800-839-2172 (TTY: 711)Individual & Family Plan (IFP) Applicants 1-877-609-8711 (TTY: 711)Group Plans through Health Net 1-800-522-0088 (TTY: 711)
If you believe that Health Net has failed to provide these services or discriminated in another way based on one of the characteristics listed above, you can file a grievance by calling Health Net’s Customer Contact Center at the number above and telling them you need help filing a grievance. Health Net’s Customer Contact Center is available to help you file a grievance. You can also file a grievance by mail, fax or email at:
Health Net of California, Inc./Health Net Life Insurance Company Appeals & Grievances PO Box 10348, Van Nuys, CA 91410-0348
Fax: 1-877-831-6019 Email: [email protected] (Members) or
[email protected] (Applicants)
For HMO, HSP, EOA, and POS plans offered through Health Net of California, Inc.: If your health problem is urgent, if you already filed a complaint with Health Net of California, Inc. and are not satisfied with the decision or it has been more than 30 days since you filed a complaint with Health Net of California, Inc., you may submit an Independent Medical Review/ Complaint Form with the Department of Managed Health Care (DMHC). You may submit a complaint form by calling the DMHC Help Desk at 1-888-466-2219 (TDD: 1-877-688-9891) or online at www.dmhc.ca.gov/FileaComplaint.
For PPO and EPO plans underwritten by Health Net Life Insurance Company: You may submit a complaint by calling the California Department of Insurance at 1-800-927-4357 or online at https://www.insurance.ca.gov/ 01-consumers/101-help/index.cfm.
If you believe you have been discriminated against because of race, color, national origin, age, disability, or sex, you can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR), electronically through the OCR Complaint Portal, at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019 (TDD: 1-800-537-7697).
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
សោកអ្នកអាចសាសារឱ្យសោកអ្នកជាភាសារបេ់សោកអ្នក។ េ្មាបជំ់នួយ េូមសៅទូរេ័ពទាសៅកានម់ជ្ឈមណ្ឌ លទំនាកទ់ំនងអតិ្ិជនតាមសលខបែលមានសៅសលើបណ័្ណ េមាគា ល់ខលៃួនរបេ់សោកអ្នក ឬសៅទូរេ័ពទាសៅកានក់ម្មវធិី Off Exchange របេ់គស្មាងជាលក្ខណៈបុគគាល និង្ករុម្គរួសារ (IFP) តាមរយៈសលខ៖ 1-800-839-2172 (TTY: 711)។ េ្មាបទី់ផ្សាររែ្ឋ California េូមសៅទូរេ័ពទាសៅកានក់ម្មវធិី On Exchange របេ់គស្មាង IFP តាមរយៈសលខ 1-888-926-4988 (TTY: 711) ឬ្ករុមហុ៊នអាជីវកម្មខ្្ន តតូចតាមរយៈសលខ 1-888-926-5133 (TTY: 711)។ េ្មាបគ់ស្មាងជា្ករុមតាមរយៈ Health Net េូមសៅទូរេ័ពទាសៅកានស់លខ 1-800-522-0088 (TTY: 711)។
Korean무료 언어 서비스입니다. 통역 서비스를 받으실 수 있습니다. 문서 낭독 서비스를 받으실 수 있으며 일부 서비스는 귀하가 구사하는 언어로 제공됩니다. 도움이 필요하시면 ID 카드에 수록된 번호로 고객서비스 센터에 연락하시거나 개인 및 가족 플랜(IFP)의 경우 Off Exchange:1-800-839-2172(TTY: 711)번으로 전화해 주십시오. 캘리포니아 주 마켓플레이스의 경우 IFP On Exchange 1-888-926-4988(TTY: 711), 소규모 비즈니스의 경우 1-888-926-5133(TTY: 711)번으로 전화해 주십시오. Health Net을 통한 그룹 플랜의 경우 1-800-522-0088(TTY: 711)번으로 전화해 주십시오.
NavajoDoo b33h 7l7n7g00 saad bee h1k1 ada’iiyeed. Ata’ halne’7g77 da [a’ n1 h1d7d0ot’88[. Naaltsoos da t’11sh7 shizaad k’ehj7 shich9’ y7dooltah n7n7zingo t’11 n1 1k0dooln77[. !k0t’4ego sh7k1 a’doowo[ n7n7zingoCustomer Contact Center hooly4h7j8’ hod77lnih ninaaltsoos nanitingo bee n44ho’dolzin7g77 hodoonihj8’bik11’ 47 doodago koj8’ h0lne’ Individual & Family Plan (IFP) Off Exchange: 1-800-839-2172 (TTY: 711). California marketplace b1h7g77 koj8’ h0lne’ IFP On Exchange 1-888- 926-4988 (TTY: 711) 47 doodagoSmall Business b1h7g77 koj8’ h0lne’ 1-888-926-5133 (TTY: 711). Group Plans through Health Net b1h7g77 47koj8’ h0lne’ 1-800-522-0088 (TTY: 711).
Persian (Farsi)خدمات زبان بدون هزينه. می توانيد يک مترجم شفاهی بگيريد. می توانيد درخواست کنيد اسناد به زبان شما برايتان خوانده شوند. برای دريافت کمک، با مرکز تماس مشتريان به شماره روی کارت شناسايی يا طرح فردی و خانوادگی IFP( Off Exchange) به شماره:
TTY:711( 1-800-839-2172( تماس بگيريد. برای بازار کاليفرنيا، با IFP On Exchange شماره 1-888-926-4988)TTY:711( يا کسب و کار کوچک 1-888-926-5133 )TTY:711( تماس بگيريد. برای طرح های گروهی از طريق
Health Net، با TTY:711( 1-800-522-0088( تماس بگيريد.
EnglishNo Cost Language Services. You can get an interpreter. You can get documents read to you and some sent to you in your language. For help, call the Customer Contact Center at the number on your ID card or call Individual & Family Plan (IFP) Off Exchange: 1-800-839-2172 (TTY: 711). For California marketplace, call IFP On Exchange 1-888-926-4988 (TTY: 711) or Small Business 1-888-926-5133 (TTY: 711). For Group Plans through Health Net, call 1-800-522-0088 (TTY: 711).
More information You can find details about our Health & Wellness programs and services on our website. Register or log in:
Group members: www.healthnet.com > Wellness Center Individual & Family Plan members: www.myhealthnetca.com > Wellness Center
Or you can call the phone number on your member ID card.
Members have access to Decision Power and myStrength through current enrollment with Health Net of California, Inc. or Health Net Life Insurance Company (Health Net). Decision Power and myStrength are not part of Health Net’s commercial medical benefit plans. They are not affiliated with Health Net’s provider network, and they may be revised or withdrawn without notice. Decision Power and myStrength services, including clinicians, are additional resources that Health Net makes available to enrollees.
Health Net of California, Inc. and Health Net Life Insurance Company are subsidiaries of Health Net, LLC. Health Net and Decision Power are registered service marks of Health Net, LLC. All other identified trademarks/service marks remain the property of their respective companies. All rights reserved.
BKT045328EO00 (7/20)